Long-term Outcome Analysis of the Supraclavicular Surgical Release for the Treatment of Thoracic Outlet Syndrome

Abstract

This study demonstrates the successful, constant long-term relief of symptoms in carefully selected patients with neurogenic and disputed TOS using the described surgical supraclavicular release technique.

Supraclavicular Scalenectomy for Thoracic Outlet Syndrome—Functional Outcomes Assessed Using the DASH Scoring System

“…15 In relation to the technique adopted in this current work, supraclavicular scalenectomy plus or minus cervical rib excision, Vogelin et al reported outcomes on a series of 22 patients (24 procedures) who underwent this procedure between 1987 and 2000; there was a significant sustained long-term improvement in quality of life for all patients ( P = .005) at a minimum of 5 years postoperatively. 16 Similarly, McCarthy et al reported their outcomes for a series of 31 patients (37 limbs) who underwent supraclavicular exploration and decompression for TOS; at a median follow-up of 12 months, no patients had deteriorated and 76% were either asymptomatic or had significantly improved and, as noted by the authors these figures are comparable with the results of previously published data on supraclavicular and TFRR. 17 In addition, in the largest case series published thus far, Hempel et al reported on 770 supraclavicular first rib resections and scalenectomies; an excellent response was achieved in 59% (455 cases) and a good result was achieved in another 27% (206 cases).…”

Neurogenic Thoracic Outlet Syndrome Reviewed

“…Shows a summary of the literature on the treatment, reported as published PubMed NTOS case series in the last 20 years. Sanders et al [13] Tender et al [15,16] Altobelli et al [27] Vegelin et al [28] Scalli et al [29] Atasoy [30] Chandra et al [31] Rochlin et al [32] Caputo et al [33] Likes et al [34] Cases whereas NTOS with objective findings on brachial plexus structure compression (known as True NTOS), considered as the "classic" form, accounts for only 1% of cases. [11,12] About 99% of neurogenic cases are characterized by clinical features of brachial plexus compression, such as pain and other symptoms, without objective findings.…”

Current practice of thoracic outlet decompression surgery in the United States

“…1 The relative paucity of information about the outcomes of surgical treatment for TOS further complicates the many points of contention about TOS. [2][3][4][5][6][7][8][9][10][11][12][13] Most published reports emanate from single institutions and describe results for a particular surgical approach or technique. Very few studies offer a more comprehensive assessment of those factors that influence the postoperative outcomes of TOS patients or provide a wider picture of the present-day surgical management of this entity.…”